TRACHEAL WIRE STENT COMPLICATIONS IN MALACIA - IMPLICATIONS OF POSITION AND DESIGN

Background. Although expandable endoluminal wire stents that can be in corporated into body tissues are very attractive for use in the airway , disease-related factors that can lead to stent failure have received little attention in the literature. Methods. The cases of all 4 patie nts who underwent insertion of one or more Gianturco stents into the t rachea, main bronchi, or both for tracheobronchial malacia in our inst itution were reviewed. Results. All three tracheal stents required rem oval for stent-related complications within the first 6 months. Compli cations included metallic strut fracture and unraveling or breakage of the encircling nylon suture leading to progressively bizarre and wide ning radiographic configurations suggesting imminent airway perforatio n. One of the six bronchial stents disrupted 10 months after insertion . Conclusions. Our findings suggest relatively less dynamic, repetitiv e bending wire stress in the bronchus (and likewise strictured trachea ) compared with the malacic trachea. Although Gianturco stents are eas ily placed and give excellent functional results, we recommend against their use in the trachea for tracheal malacia. The bronchial position may be reasonably safe. (C) 1997 by The Society of Thoracic Surgeons